MEDICARE: DR. GARY J PRICE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	023634	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	240001033	OTHER		RAILROAD MEDICARE
10	NHS527	OTHER		OXFORD & OXFORD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	061181566-002	OTHER	CIGNA
2	0Q1278	OTHER	HEALTHNET ACESSCODE932781
3	982320	OTHER	AETNA
4	061181566	OTHER	UNITED HEALTH CARE
6	023634	OTHER	CONNECTICARE
7	023634	OTHER	CONNECTICARE 65
8	061181566	OTHER	MEDSPAN
9	C45753690	OTHER	NATIONAL GRAGE MUTUAL INC
11	010023634CT02	OTHER	ANTHEM BCBS

General Provider Information

NPI Number	:	1144211616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY J PRICE MD

Provider Business Mailing Address
First Line	:	PO BOX 368
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437-0368
Country	:	US
Telephone Number	:	203-453-6635
Fax Number	:	203-458-7580

Provider Business Practice Location Address
First Line	:	5 DURHAM RD
Second Line	:	BLDG# 1, SUITE 8
City	:	GUILFORD
State	:	CT
Zip	:	06437-2076
Country	:	US
Telephone Number	:	203-453-6635
Fax Number	:	203-458-7580

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	11/12/2008

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Directions to “ DR. GARY J PRICE MD” Practice Location

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